Researchers In Texas Launch Autism Study Using Protein Supplement

Scientists at UT Southwestern
Medical Center in Dallas and Immunotec Research Ltd. have initiated a study
in which a specially formulated whey protein isolate (Immunocal)will be
used to raise glutathione levels in an attempt to lessen symptoms of

Autism is a neurological developmental disorder that affects children’s
ability to socialize normally, impairs language skills, restricts their
interests and curiosity and causes other behavioral abnormalities. Most
cases are diagnosed before three years of age, and there has been an
alarming increase in the number of cases diagnosed over the past two
decades. Currently, 1 in every 175 American children is being identified as
having autism, and these numbers are on the rise each year. To date,
medical treatment of this disorder has been minimally effective.

Although the causes of autism have not been clearly identified,
research has suggested that chronic biochemical imbalance plays a role.
Studies have shown that levels of the major intracellular antioxidant
“Glutathione” is typically about 50% lower in children with autism.
Glutathione, which is produced by every cell in the body, is responsible
for a number of functions including removing or neutralizing dangerous
substances that we are exposed to on a daily basis, including toxic metals.
Toxins, pollution, disease, stress, and poor diet can all contribute to
loss of glutathione. When glutathione levels reach a critically low degree,
we are much more vulnerable to toxins and immune dysfunction.

Principal investigator for this study is Dr. Janet Kern, an adjunct
assistant professor of psychiatry at UT Southwestern, which is
internationally recognized for its clinical and research programs.

“Some children with autism are poor detoxifiers relative to normally
developing children, and in particular, have trouble excreting toxic
metals,” said Dr. Kern. “Toxic metals that are not eliminated may build up
in the brain. Plasma glutathione has been found to be lower in children
with autism, particularly, in children with autism who have regressed. We
want to clearly establish that raising glutathione levels in these children
will improve their ability to detoxify these substances and in that way
improve some of their symptoms.”

Dr. Jill James, Professor of Pediatrics at University of Arkansas for
Medical Sciences, will be a co-investigator. Dr. James is noted for her
landmark studies in autism and toxicology and is among the first scientists
to point out the links with low glutathione levels. ” We know that
Immunocal has been used to raise glutathione in other studies very
effectively in areas such as cancer and lung disease. We want to take
advantage of this same technology”, stated James.

The team will be using a protein supplement produced by Immunotec
Research Ltd. near Montreal, Quebec, Canada, called “Immunocal”. It is
identified by the Physicians’ Desk Reference (PDR) as a glutathione
precursor. Immunotec Research Ltd. has combined rigorous research and
business acumen delivering natural healthcare and dietary supplements in 22
countries worldwide.


Revealed: Inflammatory Processes In Arteriosclerosis

Revolutionary new results concerning substances that play major roles in the inflammatory response have been published in the American scientific journal PNAS in two articles from Karolinska Institutet. Inflammation is important in, for example, cardiovascular disease. The results open the way for the development of new drugs both for prevention and for treatment.

Conditions and diseases that involve inflammation include severe infection, arthritis, asthma and arteriosclerosis. Certain substances, such as cytokines, are formed during the inflammation response and contribute to its various aspects. Professor Jesper Haeggstr?¶m and his group, working in close collaboration with Professor Jan Palmblad’s group, show in the first of two articles published in Proceedings of the National Academy of Sciences (2 May 2006) that several of these substances can influence the cells of the blood vessel wall such that they start to express receptors for a leukotriene, LTB4.

This enables the cells to react to LTB4 and to transmit signals that reinforce the inflammation. LTB4 is a powerfully chemotactic and immuno-modulating substance that is important for the motion of white blood cells over the walls of the blood vessel when the tissue becomes damaged and inflamed. It has previously been believed that the cells of the blood vessel wall are silent, unable to react to LTB4.

The demonstration of new factors that control the interplay between the blood vessel cells and the white blood cells that are crucial in the inflammatory process will enable the development of new drugs to be targeted against these factors. New drugs may in the long term become available for use during chronic inflammation such as arthritis, asthma and cardiovascular disease.

The second of the two articles presents the first report of a study that has been carried out in collaboration with arteriosclerosis researchers and surgeons at the Karolinska University Hospital, Solna. The study has investigated all enzymes and receptors that are involved in the formation and signalling of leukotrienes in arteriosclerotic tissue (hardened and calcified arteries). The experimental material has been obtained from the biobank Karolinska Endoarterectomies, in which material from patients who have received surgery for hardened arteries has been collected.

Three enzymes that have increased levels in arteriosclerotic tissue have been identified in the study; the levels of two of these enzymes are particularly highly increased in patients who are experiencing or who have recently experienced symptoms of acute vascular disease with the formation of clots. These three enzymes are vital for the formation of the immuno-modulating substance LTB4, and one of them, leukotriene A4 (LTA4) hydrolase, is particularly important. The focus that has now been placed on these critical enzymes and signal substances may accelerate the development of drugs for both the treatment and the prevention of hardening of the arteries and heart attacks.

The research at Karolinska Institutet into eicosanoids, of which both leukotrienes and prostaglandins are examples, has long been in the international vanguard. Professor Bengt Samuelsson was one of three scientists awarded the Nobel Prize in Physiology or Medicine in 1982 for the discovery of these substances, and has participated in the study on leukotrienes and arteriosclerosis. Professor Jesper Haeggstr?¶m is carrying on the work into eicosanoids and is the leader for a major EU project, EICOSANOX (eicosanox/) that is looking at these central substances and the role they play in several major widespread diseases: cardiovascular disease, arteriosclerosis, dementia and cancer.


“Differential induction of BLT receptor expression on human endothelial cells by lipopolysacharide, cytokines, and leukotriene B4″. Qui H, Johansson A-S, Sjostrom M. Wan M, Schroder O, Palmblad J, Haeggstrom JZ. PNAS 103: 6913-18, 2 May 2006.

“Expression of 5-lipoxygenase and leukotriene A4 hydrolase in human arterosclerotic lesions correlates with symptoms of plaque instability”. Qui H, Gabrielsen A, Agardh HE, Wan M, Wetterholm A, Wong C-H, Hedin U, Swedenborg J, Hansson GK, Samuelsson B, Paulsson-Berne G, Haeggstrom JZ. PNAS 103:8161-6,12 May 2006.

For more information, please contact:
Professor Jesper Z. Haeggstrom

Contact: Sara Alden

Karolinska Institutet

Drugs Being Tested For Alzheimer’s Disease Work In Unexpected And Beneficial Ways

Researchers at Mayo Clinic, with their national and international collaborators, have discovered how a class of agents now in testing to treat Alzheimer’s disease work, and say they may open up an avenue of drug discovery for this disease and others.

In the June 12 issue of Nature, they report that agents known as gamma-secretase modulators (GSM) work to reduce production of long pieces of the amyloid beta protein (Abeta) that readily stick together and form clumps, and increase production of shorter Abeta that can inhibit the longer forms from sticking together.

This is critical because only when Abeta aggregates and accumulates is it harmful and can trigger Alzheimer’s disease, the researchers say.

“So, as these compounds lower the amount of the bad, longer sticky Abeta peptides in the brain, they increase the quantity of shorter Abeta peptides that may protect against development of Alzheimer’s disease,” says senior author Todd Golde, M.D., Ph.D., Chair of the Department of Neuroscience at Mayo Clinic in Jacksonville.

“In a very general sense the action of these GSM on Abeta might be analogous to some cholesterol lowering drugs that can lower LDL, the bad cholesterol that sticks to your arteries, and can raise HDL, the good cholesterol that sweeps out LDL,” he says.

Not only that, GSM agents actually stick to the Abeta already in the brain, keeping it from aggregating. A hallmark of Alzheimer’s is formation of “plaques” and other assemblies of Abeta protein in the brain, which are believed to damage neurons in complex ways that are not yet fully understood, researchers say. “Surprisingly, this means that these compounds may do three things that may be beneficial with respect to Alzheimer’s disease: they inhibit production of long Abeta, block aggregation of Abeta, and increase production of shorter Abeta peptides that may in turn inhibit Abeta aggregation,” says the study’s lead investigator, Thomas Kukar, Ph.D.

As exciting as these discoveries are, the investigators which number 29 in all and are from four nations – also found that GSMs work in a way that has not been seen before in other drugs. “Most drugs target enzymes, which act on proteins, or cell surface receptors, which proteins bind to,” he says. “These agents work on the structure, or substrate, of the protein itself, which had not been believed to be druggable.”

“This broadens the notion of what drugs can do, and therefore, has wide reaching implication for future drug discovery for many different disorders,” Dr. Golde says.

The findings also suggest that GSMs now being tested or in development to treat Alzheimer’s may prove to be valuable, the researchers say. One such drug, tarenflurbil (FlurizanTM), is in Phase III clinical trials, and results from the first, a 1,600-patient US study, are expected this summer. Results of a phase II study, published online in April in Lancet Neurology, suggest it provides benefit in patients with mild Alzheimer’s, Dr. Golde says.

Understanding the agent Mayo discovered

Mayo Clinic helped discover that tarenflurbil was a GSM. Previously, Dr. Golde, along with Eddie Koo, M.D., of the University of California at San Diego, found that the agent tarenflurbil, then called r-flurbiprofen, inhibited production of Abeta 42, and increased the quantity of the shorter Abeta38 but they did not know why. Myriad Genetics, a biotechnology company, had been testing the drug to treat prostate cancer, an indication that is not currently being pursued. But after cell and animal studies in the laboratories of Dr. Golde and Dr. Koo suggested that tarenflurbil could influence Abeta production and reduce cognitive deficits in a mouse model of AD, the company began testing it to treat Alzheimer’s in humans.

At the same time, Mayo researchers, led by lead investigator Thomas Kukar, Ph.D., worked to understand how tarenflurbil and other so-called GSMs work. The Abeta protein is normally generated from a larger protein (the amyloid precursor protein) by the sequential cutting action of two different enzymes that act as molecular scissors. Such enzymes that cut other proteins are referred to as proteases. First the protease, beta-secretase, cuts the protein above the cell membrane. A second protease, gamma-secretase, then clips the portion that sticks inside the cell. Where gamma-secretase cuts the amyloid precursor protein determines how long the Abeta peptide will be. The most commonly produced fragment is Abeta 40, but some are longer (Abeta 42) and some, such as Abeta 38, are shorter. None clump together as quickly as Abeta 42 does, however, and emerging evidence indicates that these shorter pieces may actually keep the longer Abeta 42 from clumping together.

The discovery of gamma-secretase initially led to development of agents designed to block its action. One strategy was to directly target and block gamma-secretase, but because the protease acts on many different proteins, this approach proved to be too toxic, Dr. Golde says. Companies then focused on developing “selective” scissor targeting gamma-secretase inhibitors that predominantly inhibit Abeta production without affecting other targets of the protease. At least one such compound, tarenflurbil, is in clinical trials with several more expected to be entering human trials over the next year or two.

Researchers at Mayo thought that tarenflurbil must also be directly targeting gamma-secretase, but it took almost three years of experimentation using multiple methods to discover that the agent actually acts on the substrate of the scissors the amyloid precursor protein itself. It is thought that the compounds somehow push the protein around in the membrane so that when the gamma-secretase scissors finally cut it, toxic abeta 42 fragments are not produced.

Relevance for future drug discovery

“We now think most GSMs, including tarenflurbil, work this way,” Dr. Kukar says. “This is one of the few examples of a small molecule drug that targets a protein substrate rather than the enzyme that works on it, and from a therapeutic point of view, that can offer many beneficial effects.”

“If results from tarenflurbil and other GSM agents are less beneficial than hoped, these findings may help drug designers create newer, more potent drugs,” Dr. Golde says. “Anytime we gain an increased understanding of the precise molecular action of a drug, that enhances our ability to make better drugs.”

The study was funded by grants from the National Institute on Aging, the American Federation for Aging Research Rotary CART Fund, the American Health Assistance Foundation, and Mayo Clinic. Mayo Clinic and the University of California own a joint patent on Abeta42 lowering compounds and their use for treating AD, which the institutions licensed to Myriad Genetics, Inc.

Dr. Golde has sponsored research funded by Myriad Genetics.

Study co-authors include researchers from the Swiss Federal Institute of Technology in Lausanne, Switzerland; Harvard Medical School; the Technische Universitaet in Darmstadt, Germany, University College in Dublin, Ireland; and the University of California at San Diego.

Mayo Clinic
200 First St. SW
Rochester, MN 55902
United States

Brain Differences Could Explain Why Males And Females Experience Pain Relief Differently

A study conducted by investigators at Georgia State University and the Atlanta-based Center for Behavioral Neuroscience (CBN) reports that anatomical and functional differences in the brain may explain sex differences in the experience of pain and in the effects of certain drugs on pain.

The finding, reported in the April issue of the Journal of Comparative Neurology, is the first report of specific differences in the parts of the brain responsible for the transmission of pain sensations in the body. The study used rat brains, but a host of clinical evidence suggests that similar differences occur in humans – in other words, this finding could eventually lead to the development of differential treatments for pain in men versus women.

A team led by Dr. Anne Murphy of the Georgia State Department of Biology and the CBN showed that male and female rodents are anatomically different in the area of the brain called the periaqueductal gray (PAG). This region of the brain relays information regarding pain to another brain region, the rostral ventral medulla (RVM). This PAG-RVM circuit is the main pain circuit in the brain, and is responsible for the sensation of pain. Both narcotics and analgesics work by acting on these brain regions. Interestingly, while thousands of studies have been conducted examining the role of the PAG and the RVM in pain and analgesia, these studies were conducted exclusively in males. The study by Murphy is the very first to examine if these brain regions are organized anatomically in a similar manner in females. In addition to sex differences in how the PAG is organized anatomically, the team went on to show that persistent pain activates this pathway differently in males and females. Specifically, the scientists showed that inflammatory pain activated the PAG-RVM circuit to a greater degree in males than in females. Morphine – an opioid drug or narcotic – reduced the response of this circuit to pain to in males, but not females.

These results provide the first potential anatomical and functional explanation for sex differences in the experience of pain and responses to the drug morphine in the treatment of pain.

Morphine is currently the drug of choice for treating several types of post-operative pain, and it is becoming increasingly clear that morphine alleviates pain to a greater degree in males in comparison to females. The results of the study by Murphy and Loyd provide important details about how morphine might be used differently in females and males to achieve maximum pain relief.

Pain is one of the most common reasons that people consult physicians. Thus, the management of pain has become one of the highest priorities in health care. Chronic pain from inflammatory conditions such as arthritis and fibromyalgia are the most prevalent and pervasive forms of chronic pain.

Clinical evidence suggests that women are much more likely to experience chronic forms of pain than are men and that women report feeling more pain than men following various medical procedures.

Recent recommendations from the American Academy of Pain Medicine and the American Pain Society indicate that opioid drugs or “narcotics”, such as morphine, are essential in the management of chronic pain. However, there is well-established clinical and nonclinical evidence that males and females do not respond the same to the effects of morphine. Specifically, females tend to require higher doses of morphine than males for pain relief following various medical procedures.

The co-authors of Murphy’s study include graduate student Dayna Loyd, doctoral candidate in the Dept. of Biology at GSU. These studies were supported by a research grant from the National Institute of Health.

CBN, a National Science Foundation Science and Technology Center, is a research and education consortium of eight metro Atlanta colleges and universities. More than 90 neuroscientists lead the interdisciplinary research program to understand the neurobiology of complex social behaviors. CBN studies have led to breakthrough treatment for anxiety-related disorders and new understanding of the neurochemicals vasopressin and oxytocin in social behavior. In addition to research, CBN has a comprehensive education program designed to improve science literacy and attract more women and underrepresented minorities to neuroscience programs. The center is supported by more than $53 million in grants from NSF and the Georgia Research Alliance.

Contact: Ann Claycombe
Georgia State University

USU Participates In Mass Casualty Exercise

A number of centers and institutes of the Uniformed Services University of the Health Sciences (USU) will be among the participants in a collaborative multi-agency emergency preparedness conference and exercise here December 7.

Faculty and staff from USU’s Armed Forces Radiobiology Research Institute (AFRRI), Center for Disaster and Humanitarian Assistance Medicine (CDHAM), the National Capital Area Patient Simulation Center, and the Center for the Study of Traumatic Stress (CSTS) will provide on-site expertise in the treatment of chemical, nuclear, biological and radiological injuries and dealing with the stress associated with a disaster or other catastrophic incident.

Also participating is a “moulage” team from the university. These special effects makeup artists are experts at creating realistic injuries that are key to the education and training of health care personnel and first responders in combat or public health disasters.

The joint mass casualty exercise will be held on the grounds of the National Naval Medical Center to test and evaluate the interoperability of the Bethesda Hospitals Emergency Preparedness Partnership’s personnel with local, state and federal agencies. Other participants include NNMC, Suburban Hospital, the National Institutes of Health Clinical Center, and first responders from throughout the local area.

USU is the nation’s federal school of medicine and graduate school of nursing. The students are active-duty uniformed officers in the Army, Navy, Air Force and U.S. Public Health Service who are being educated to deal with wartime casualties, national disasters, emerging infectious diseases and other public health emergencies.

For more information about USU, please visit the website at

Uniformed Services University of the Health Sciences (USU)
4301 Jones Bridge Rd.
Bethesda, MD 20814-4799
United States

WFP Provides Food To Thousands Displaced By Conflict In Georgia

The United Nations World Food Programme (WFP) has
providing food assistance to more than 2,000 people displaced by
escalating conflict in Georgia, where hundreds of people have been
and thousands more have fled their homes since fighting began in the
of South Ossetia on Friday.

Over the weekend, in response to a request from the Georgian
WFP provided a 10-day food ration to more than 1,900 displaced
living in shelters in the capital, Tbilisi; more distributions are
place today. WFP has been drawing on food aid stocks from
programmes in Georgia.

“The number of people in need of our help is rising by the hour,” said
Georgia Country Director Lola Castro, adding that so far, 2,750
people had been registered in Tbilisi alone. She said many more people
living with relatives or in unofficial shelters.

Today’s distributions are mainly targeted at people outside the
However, access to them is restricted by continuing Russian air
making it extremely dangerous for WFP staff trying to reach them.

Many of the displaced have no access to cooking facilities therefore
will provide High Energy Biscuits, which require no preparation, over
coming days.

WFP will also offer its logistical support to other humanitarian
organisations, using capacity from its existing food assistance operation
in the country which was targeted at 212,000 people — mainly poor rural
communities — as well as primary schoolchildren, tuberculosis patients
and people living with HIV/AIDS.

Tens of thousands of people have fled South Ossetia over the past
days. Many of them have been displaced in other parts of Georgia.
Russian Government says about 30,000 people have crossed the border
neighbouring North Ossetia, inside the Russian Federation where
government says it will take care of the humanitarian needs.

On Sunday, WFP carried out a joint assessment with the UN refugee
(UNHCR) in Gori, which has also been affected by the conflict, and
the town – with a population of about 40,000 – to be almost deserted.

WFP is the world’s largest humanitarian agency and the UN’s frontline
agency for hunger solutions. This year, WFP plans to feed around 90
people in 80 countries.


Red Cross Preparing For Hurricane Earl From North Carolina To New England

The American Red Cross is ready to respond to Hurricane Earl from North Carolina to New England, preparing to open shelters and feed those affected by the Category 3 storm that is bearing down on the United States, bringing heavy rains and sustained winds blowing at 125 mph.

“We are making preparations for Earl’s landfall, and we urge everyone who may be in the path of the storm to also get prepared and follow the instructions of local authorities about evacuating,” said Joe Becker, senior vice president, Red Cross Disaster Services. “Indications are that the storm will affect those who are miles inland from the coast. Being ready is your best protection against a storm like this.”

All along the eastern seaboard, the Red Cross is working with various state, county and local government officials to determine what their areas will need. Emergency planning is taking place in North Carolina, South Carolina, New York, Massachusetts, Virginia, Maryland, Delaware, New Jersey, Pennsylvania, Connecticut, Rhode Island, Vermont, New Hampshire and Maine.

In North Carolina, evacuation orders have been issued for some of the barrier islands. Earl could arrive in the state by late Thursday or early Friday, and the Red Cross has 14 shelters ready to open with more than 80 additional shelter sites identified if needed. Updated shelter location information is readily available on the Red Cross website by clicking “Find a Shelter.”

People who are evacuating can register on the Red Cross Safe and Well Website, accessible here, so that friends and relatives can find out how they are. For those who don’t have internet access, call 1-800-RED CROSS (1-800-733-2767) to register yourself and your family. Follow the prompts for disaster information.

The Red Cross has trained disaster workers from across the country on alert to help respond to Hurricane Earl. Nearly 40 Red Cross mobile response vehicles will arrive in North Carolina today, part of more than 150 of these response vehicles put on alert to travel to the East Coast from as far away from the coast as Michigan and Wisconsin.

The Red Cross has four warehouses stocked with relief supplies are on stand-by, and two trailers of relief supplies are en route to North Carolina, carrying clean-up kits, tarps, work gloves, comfort kits, and trash bags.

The National Hurricane Center has issued a Hurricane Warning for the East Coast from Bogue Inlet, North Carolina to southern Virginia. A Hurricane Watch has been extended northward from the North Carolina-Virginia border to Cape Henlopen, Delaware. Residents all along the coast all the way to New England are cautioned to pay attention to the storm. Other areas of North Carolina are under a Tropical Storm Watch.

A Hurricane Warning means hurricane conditions are expected within 36 hours and anyone in the warning area should complete their storm preparations and leave the area if told to do so by authorities. A Hurricane Watch means hurricane conditions are a threat within the next 48 hours and people should be ready to act if a Hurricane Warning is issued.

If someone’s community is under a Hurricane Warning or Watch, they should listen for critical information from the National Weather Service. Other steps they should take include:

– Check disaster supplies and restock as needed.

– Bring in anything that can be picked up by the wind.

– Close windows, doors and hurricane shutters. If hurricane shutters aren’t available, board up all windows and doors with plywood.

– Fill the car’s gas tank.

– Turn the refrigerator and freezer to the coldest setting and keep them closed as much as possible so food will last longer if the power goes out.

– Turn off propane tanks and unplug small appliances.

– Make plans for any pets.

– Evacuate if authorities advise to do so.

More information about what people can do if they are in the projected path of the storm can be found here.

The storms in the Atlantic Ocean are causing powerful rip currents. The Red Cross advises anyone visiting the shore areas to swim only on lifeguard protected beaches and within designated swimming areas.

To make a financial donation to the Red Cross to help people affected by this storm and other disasters here in the United States and around the world, people can click, call or text – visit here, call 1-800-RED CROSS, or text the word REDCROSS to 90999 to make a $10 donation. The storm may also impact blood collections in the affected areas. To find out how you can be a blood donor, visit here.


American Red Cross

UNICEF Calls For Intensified Efforts To Bolster Disaster Risk Reduction Measures To Protect The Most Vulnerable Children

As the world marks the International Day for Disaster Risk Reduction on 13 October, UNICEF today urged governments and civil society partners to step up efforts to help mitigate the impact of disasters – especially on children – by helping communities to become resilient, and more able to respond to disasters and changing climate conditions.

Children typically represent 50 to 60 per cent of those affected by disasters, whether through loss of life or from diseases related to malnutrition and poor water and sanitation-conditions that are exacerbated by disasters. In addition, disasters disrupt education and can cause psychological distress, and present issues of exploitation of children, creating more vulnerability.

Education, public awareness, community-based preparedness, teaching life skills, as well as disaster-resilient public buildings are all ways to reduce risk reduction for children.

UNICEF is redoubling efforts globally to reduce the risks associated disasters. In Bangladesh, more children die from drowning, than any other country in the world. Some 17,000 children drown each year. With risks increasing due to climate change, extreme weather patterns, frequent flooding and rising sea levels, UNICEF and its partners have taught Bangladeshi children how to swim. As of last year, 35,000 Bangladeshi children have been taught to swim, and many have learned life-saving techniques.

Recent trends show increased frequency and intensity of natural disasters: heat waves, floods, droughts, cyclones and earthquakes.

Climate change, particularly when coupled with underdevelopment, environmental degradation, and urbanization, is becoming one of the most important drivers of disaster risk.

UNICEF is increasingly concerned that disasters are disproportionately affecting the most vulnerable, eroding hard-won development gains and setting back progress toward the Millennium Development Goals. High-income countries are exposed to 39 per cent of tropical cyclones while bearing only 1 per cent of the mortality risk. In comparison, low-income countries face 13 per cent of the exposure, but over 80 per cent of the mortality risk.

This year has already witnessed massive emergencies with the earthquake in Haiti and floods in Pakistan, as well as landslides in China and wildfires in Russia.

Schools have proven to be key avenues for disaster reduction implementation. UNICEF increasingly advocates for sustainable school construction and disaster-oriented education in risk-prone countries and regions.

In Madagascar, UNICEF and its partners engaged in training teachers and staff in minimum standards to follow in emergencies, distributing disaster risk manuals in schools and conducting needs assessments. As a result, in the aftermath of two cyclones last year, no school children were harmed and schooling in some regions was restored in just eight days.

In a separate effort in Zimbabwe, UNICEF is reviewing its WASH programme from the perspective of disaster risk, preventing wells and latrines from being destroyed and reducing the likelihood of a disaster-related cholera outbreak.

Still, much more must be done to reduce disaster risk. Funding gaps, particularly in developing countries, persist. Some progress has been made through social funds and risk financing, but there needs to be much greater investment and commitment for disaster risk reduction.


This year, city mayors in particular have been invited to commit to measures of risk reduction under the banner “Making Cities Resilient,” A campaign launched by the UN International Strategy for Disaster Risk. One hundred cities have joined the campaign and more than a dozen cities and towns around the world will hold events to mark the day, including public awareness campaigns, film screenings, seminars and conferences.

The United Nations declared the 1990s the first ‘International Decade for Disaster Reduction’ leading to the formation of the International Strategy for Disaster Reduction (ISDR) in 2000. The ISDR Secretariat is tasked with supporting governments in the implementation of The Hyogo Framework for Action: 2005 – 2015 ‘Building the Resilience of Nations and Communities to Disaster’ adopted by 168 member states.



Genes That Increase Rheumatoid Arthritis Risk Identified By Researchers

Researchers in the United States and Sweden have identified a genetic region associated with increased risk of rheumatoid arthritis (RA), a chronic and debilitating inflammatory disease of the joints that affects an estimated 2.1 million Americans. The U.S. arm of the study involved a long-time collaboration between intramural researchers of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) and other organizations. NIAMS is one of 27 institutes and centers at the National Institutes of Health. The results appeared in the New England Journal of Medicine.

Using the relatively new genome-wide association approach — which makes it possible to analyze between 300,000 and 500,000 single nucleotide polymorphisms (SNPs, or small differences in DNA that are distributed throughout a person’s genetic code) — researchers in both countries searched for genetic differences in blood samples from people with RA compared to controls. The U.S. group compared 908 samples from patients provided by the North American Rheumatoid Arthritis Consortium (NARAC) — a group of investigators working together to identify the genetic factors that contribute to RA — with those from 1,282 people without RA (controls). The Swedish group compared 676 samples from the Swedish Epidemiological Investigation of Rheumatoid Arthritis (EIRA) with 673 controls.

Both groups’ searches led them to a region of chromosome 9 containing two genes relevant to chronic inflammation: TRAF1 (encoding tumor necrosis factor receptor-associated factor 1) and C5 (encoding complement component 5).

“The whole-genome screening method lets us identify genes that contribute to disease-susceptibility without imposing our preconceived notions of the disease. We expected to come up with something new,” says Elaine F. Remmers, Ph.D., of the Genetics and Genomics Branch of the NIAMS Intramural Research Program and an author of the study. “We were thrilled to find out that TRAF1-C5 showed association not only in the samples that we did with NARAC but also independently in the Swedish group. By combining our information, we were able to make a much stronger case [for a TRAF1-C5 association]. The combined evidence was pretty impressive.”

Remmers says the TRAF1-C5 region was the third of three major susceptibility chromosomal regions for RA identified by their whole genome screen. The first two, HLA-DRB1 and PTPN22, had already been well established.

She says that it’s not yet known how the genes in the TRAF1-C5 region influence RA risk. Nor can scientists say which of the two genes is causing the disease. “Actually, both genes are very interesting candidates,” she says. “They both control inflammatory processes that really are relevant for the disease, so we could easily envision either of them playing a role — or both.”

The hope is that by learning more about the genes and their role in the disease, scientists may find clues to influencing treatment of the disease. “We are hoping that we will find variants in either of the genes that will lead us to new targets for therapy. Once we understand how the RA-associated variants work, we may be able interfere with the pathways the variants are influencing and either prevent the disease or block its progression.”

According to coauthor Daniel Kastner, M.D., Ph.D., NIAMS clinical director and chief of the NIAMS Genetics and Genomics Branch, “The success of the study can be attributed in part to the productive, longstanding collaboration between NIAMS intramural researchers and other scientists that the Institute supports around the country.” NARAC was established 10 years ago by coauthor Peter K. Gregersen, M.D., at the Feinstein Institute for Medical Research, the North Shore Long Island Jewish Health System, in order to facilitate the collection and analysis of RA genetic samples. Kastner was also a key early member of the NARAC, as were many other investigators at several academic health centers across the United States.

In addition to NIAMS, other support for the U.S. study came from the National Center for Research Resources, the Arthritis Foundation, grants from the Boas Family and the Eileen Ludwig Greenland Center for Rheumatoid Arthritis (Feinstein Institute for Medical Research), the Rosalind Russell Medical Research Center for Arthritis and the Kirkland Scholar Award (University of California, San Francisco).

Support for the Swedish arm of the study came from the Swedish Medical Research Council, the Swedish Council for Working Life and Social Research, the King Gustaf V’s 80-Year Foundation, the Swedish Rheumatism Foundation, the Stockholm County Council, the AFA insurance company and the Agency for Science Technology and Research, Singapore.

The mission of the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), a part of the Department of Health and Human Services’ National Institutes of Health, is to support research into the causes, treatment and prevention of arthritis and musculoskeletal and skin diseases; the training of basic and clinical scientists to carry out this research; and the dissemination of information on research progress in these diseases. For more information about NIAMS, visit the NIAMS Web site at niams.nih/.

The National Center for Research Resources (NCRR) provides clinical and translational researchers with the training and tools they need to understand, detect, treat, and prevent a wide range of diseases. For more information about NCRR visit ncrr.nih/.

The National Institutes of Health (NIH) — The Nation’s Medical Research Agency — includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit nih/.

Reference: Plenge RM et al. TRAF1-C5 as a risk locus for rheumatoid arthritis — a genomewide study. NEJM 2007;357:1199 -1209.

Source: Trish Reynolds

NIH/National Institute of Arthritis and Musculoskeletal and Skin Diseases

Steroid Nasal Sprays Relieve Sinusitis Symptoms, Review Finds

Every year, nearly 37 million Americans suffer from the sinus pressure, nasal congestion, cough and postnasal drip that accompany sinusitis.

Doctors often prescribe antibiotics to relieve acute sinusitis, which can develop following a chest cold. However, steroid nasal sprays either alone or with antibiotic therapy may better ease symptoms and speed recovery, suggests a new review by Israeli researchers.

Sinusitis is an inflammation of the mucous membranes that line the sinus cavities. Steroid sprays like Flonase, Nasonex and Rhinocort, which work by reducing inflammation to promote drainage in the sinuses, are often prescribed to treat chronic sinusitis and allergies symptoms.

But the use of steroids sprays for acute sinusitis is not as universally accepted.

In this review, Anca Zalmanovici, a family physician at Rabin Medical Center in Petach Tikva, and her co-author analyzed data from four randomized controlled trials including nearly 2,000 participants, all with clinical symptoms of acute sinusitis.

The review appears in the current issue of The Cochrane Library, a publication of The Cochrane Collaboration, an international organization that evaluates research in all aspects of health care. Systematic reviews draw evidence-based conclusions about medical practice after considering both the content and quality of existing trials on a topic.

Two of the studies evaluated patients at treatment centers in the United States, one took place in Turkey and the other included 71 medical centers in 14 countries.

Study participants, who underwent X-rays or nasal endoscopy to confirm diagnosis, received either a placebo or intranasal corticosteroids for two or three weeks, alone or in combination with antibiotics. Intranasal corticosteroids used included fluticasone propionate (Flonase), mometasone furoate (Nasonex) and budesonide (Rhinocort).

Overall, 73 percent of the patients treated with nasal steroids experienced relief or marked improvement of symptoms during the study period, compared with only 66.4 percent of patients who received the placebo.

“For every 100 patients treated with intranasal corticosteroids, seven additional patients had complete or marked symptom relief,” compared to those in the placebo group, the reviewers found.

Researchers pooled data from three of the four studies, excluding the lowest-quality study from the statistical analysis.

None of the studies reported serious side effects, and rates of sinusitis relapse were similar between the treatment and placebo groups.

Stronger doses of nasal steroids appeared to work better. Patients receiving daily doses of 400 micrograms were more likely to experience relief of sinusitis symptoms, than were patients receiving 200-microgram doses.

Although there is not enough evidence to suggest that nasal steroids can stand alone for acute sinusitis treatment, “the results of these studies and reviews support the current clinical rationale of adding an intranasal corticosteroid to antibiotic therapy,” reviewers say.

Allen Seiden, M.D., director of the University of Cincinnati Taste and Smell Center, said that more data are required before routine recommendations on intranasal corticosteroids can be made.

“It seems to have been a well-conducted review, with thorough statistical analysis. However, in the end, it analyzed relatively few studies,” Seiden said.

He added that the review lacked information about how individual diagnoses were made, and said that even with X-rays and nasal endoscopy, distinguishing between viral and bacterial infections can be difficult, a problem that may influence the choice of treatment.

When it comes to treating sinus infections, “patients vary as to when they will seek medical intervention. Some will come in after only a day or two of symptoms; some not for two to three weeks,” Seiden said. Longer waits can make symptoms harder to treat, he said, “while many patients with symptoms for only a few days will in fact have a viral infection.”

Although there are few downsides to using nasal steroids such as those in the review they are fairly expensive, Seiden said. According to the National Institute of Allergy and Infectious Diseases, diagnosing and treating sinusitis costs Americans nearly $6 billion every year.

Zalmanovici A, Yaphe J. Steroids for acute sinusitis (Review). Cochrane Database of Systematic Reviews 2007, Issue 2.

The Cochrane Collaboration is an international nonprofit, independent organization that produces and disseminates systematic reviews of health care interventions and promotes the search for evidence in the form of clinical trials and other studies of interventions. Visit cochrane for more information.

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